The Time spent per day in strenuous activity and total physical activity are inversely associated with mucosal healing but not with clinical remission in patients with ulcerative colitis

Authors Junichi Watanabe, Shinya Furukawa, Sen Yagi, Kana Shiraishi, Masakazu Hanayama, Kazuhiro Tange, Yu Hashimoto, Shogo Kitahata, Kenichirou Mori, Tomoyuki Ninomiya, Seiyyu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Aki Hasebe, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda, Yoichi Hiasa.


Background Epidemiological evidence on the association between physical activity (PA) and ulcerative colitis (UC) is limited, and the effect of PA on the prognosis of UC is currently unknown. We evaluated the association between PA and clinical outcomes, including clinical remission and mucosal healing (MH), in Japanese patients with UC.

Methods The study subjects were 327 Japanese patients with UC. Subjects were asked about the average time spent per day on 4 types of PA (sedentary, standing, walking, and strenuous activity) and metabolic equivalents (METs) using a validated questionnaire. Clinical outcomes were complete MH, MH, and clinical remission. The association between PA, including hours spent on each type of PA and average daily METs, and clinical outcomes was assessed by multivariate logistic regression.

Results Plentiful strenuous activity was significantly inversely associated with MH and complete MH after adjustment (MH: adjusted odds ratio [OR] 0.45, 95% confidence interval [CI] 0.23- 0.89; complete MH: adjusted OR 0.24, 95%CI 0.07-0.62; P for trend=0.008). A very high daily MET total was significantly inversely associated with complete MH after adjustment (adjusted OR 0.37, 95%CI 0.16-0.80; P for trend=0.010). In contrast, no association between PA and clinical remission was found (plentiful strenuous activity: adjusted OR 1.10, 95%CI 0.55-2.23; very high daily total METs: adjusted OR 0.74, 95%CI 0.37-1.46).

Conclusion In Japanese patients with UC, time spent per day on strenuous activity and total PA per day may be significantly inversely associated with complete MH, but not with clinical remission.

Keywords Mucosal healing, exercise, clinical remission, ulcerative colitis, metabolic equivalents

Ann Gastroenterol 2021; 34 (6): 796-801

Original Articles